光活化牙齿漂白治疗效果及对牙体硬组织的影响

doi:10.12337/zgkqjxjyzz.2025.05.008

中国口腔医学继续教育杂志 ›› 2025, Vol. 28 ›› Issue (5): 353-359.DOI: 10.12337/zgkqjxjyzz.2025.05.008

光活化牙齿漂白治疗效果及对牙体硬组织的影响

刘畅, 赵晓一^*

北京大学口腔医学院·口腔医院综合治疗科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心

出版日期:2025-09-30 发布日期:2025-09-30
通讯作者: ^* 赵晓一,联系方式：010-82195586,电子邮箱：xiaoyi_zhao@bjmu.edu.cn,通讯地址：北京市海淀区中关村南大街22号,100081
基金资助:
北京大学口腔医院2024年度临床新技术新疗法项目（项目编号：PKUSSNCT-24B06）

Light-Activated Tooth Whitenings: Effectiveness And Effects On Dental Hard Tissues

Chang Liu, Xiaoyi Zhao^*

Department of General Dentistry,Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, P.R. China

Online:2025-09-30 Published:2025-09-30
Contact: Xiaoyi Zhao. Tel: 010-82195586. Email: xiaoyi_zhao@bjmu.edu.cn. Address: No.22, Zhongguancun South Avenue, Haidian District, Beijing 100081, P.R. China.

摘要/Abstract

摘要： 目的：评价不同辅助光源牙齿漂白对牙体硬组织颜色、微硬度及表面溶解的影响。材料与方法：分别制备30颗人前磨牙、60颗牛牙釉质和30颗牛牙本质标本,用于牙齿漂白效果、表面微硬度和表面溶解量评估。将人前磨牙分为3组,分别用35%过氧化氢凝胶联合卤素和LED光源处理3×10分钟（混合组）,单独用LED光源处理3×12分钟（LED组）,或无光处理3×10分钟（无光源组）。依据 CIEDE2000 色差公式使用牙科分光光度计及VITA比色板评估牙齿颜色变化。用相同方案处理牛牙釉质和牙本质表面,以评估漂白对牙釉质表面微硬度以及牙釉质和牙本质表面组织溶解的影响。同时将牙釉质和牙本质组织溶解与阳性对照（1%柠檬酸）和阴性对照（蒸馏水）进行比较。使用Tukey检验的方差分析比较研究组之间的结果。结果：混合组和LED组的漂白效果在颜色改善方面明显优于无光源组,颜色改变∆E00分别为3.4±1.3、3.1±0.8、1.9±0.6（P<0.05）,VITA比色各组分别提高3.5±0.53、3.5±0.97和1.7±1.16个色阶。所有3组的牙釉质表面微硬度均略有下降（分别为6.4±2.5%、4.0±1.8%、4.2±2.4%,P>0.05）。仅阳性对照组出现明显的牙釉质或牙本质组织溶解（牙釉质4.3±0.7µm,牙本质6.7±1.0µm）,阴性对照组和3个漂白组均未出现这种情况（范围为0.01~0.18µm）。结论：与不使用光源相比,使用两种光源进行牙齿漂白均能改善牙齿颜色,但仅使用LED灯需要稍长的治疗时间才能达到相同的漂白效果。使用35%过氧化氢进行牙齿漂白治疗（无论是否使用光源）均不会引起牙齿硬组织表面发生明显变化。

关键词: 漂白治疗, 效果, 表面微硬度, 表面溶解量, 光活化

Abstract: Objective: To evaluate the effects of tooth whitening with different auxiliary light sources on color, microhardness and surface dissolution amount of dental hard tissues. Material and Methods: A total of 30 human premolars, 60 bovine enamel and 30 bovine dentin specimens were prepared for whitening, surface microhardness and erosive tissue loss assessments, respectively. Human teeth were divided into 3 groups and treated with 35% hydrogen peroxide gel combined with halogen and LED lights for 3×10 minutes (HAL group), with LED alone (LED group) for 3×12 minutes, or with no light for 3×10 minutes (NLC group). Tooth color changes were assessed with a dental spectrophotometer using CIEDE2000 and visual analysis using the Vitapan shade guide. Bovine enamel and dentin surfaces were treated with the same protocols to assess the effects of whitening on enamel surface microhardness and enamel and dentin surface tissue loss. Enamel and dentin tissue losses were also compared to a positive (1% citric acid) and a negative control (distilled water). Analysis of variance (ANOVA) with Tukey tests were used to compare findings among the study groups. Results: Whitening outcomes were significantly better in the HAL and LED groups than in the NLC group in color improvements as shown by∆E00 values (3.4±1.3, 3.1±0.8, 1.9±0.6 respectively, P<0.05). The mean shade improved 3.5±0.53, 3.5±0.97 and 1.7±1.16 respectively according visual analysis. Slight decreases in enamel surface microhardness occurred in all 3 groups (6.4±2.5%, 4.0±1.8%, 4.2±2.4% respectively, P>0.05). Significant enamel or dentin tissue loss occurred only in the positive control (4.3±0.7µm in enamel, 6.7±1.0µm in dentin) but not the negative control and the 3 whitening groups (range 0.01-0.18µm). Conclusions: Tooth whitening with either type of light sources improved the whitening outcomes compared to no light, though the LED light alone needed a slightly longer treatment duration to reach the same whitening outcomes. Whitening treatments with 35% H₂O₂ with or without lights did not cause significant surface changes of dental hard tissues.

Key words: bleaching, effects, microhardness, surface dissolution amount, light activate

刘畅, 赵晓一. 光活化牙齿漂白治疗效果及对牙体硬组织的影响[J]. 中国口腔医学继续教育杂志, 2025, 28(5): 353-359.

Chang Liu, Xiaoyi Zhao. Light-Activated Tooth Whitenings: Effectiveness And Effects On Dental Hard Tissues[J]. Chinese Journal of Stomatological Continuing Education, 2025, 28(5): 353-359.

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光活化牙齿漂白治疗效果及对牙体硬组织的影响

Light-Activated Tooth Whitenings: Effectiveness And Effects On Dental Hard Tissues

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